Bone and Joint Disease Spondos in here Flashcards
Objectives:
- List and describe major skeletal disorders
- Explain the healing process of bones following common types of fractures.
What system
- Provides body framework, support and movement
- Protects internal organs
- Stores calcium
- Produces blood cells
Functions of the Musculoskeletal System:
What makes up the Musculoskeletal System?
Muscles Tendons
Bones Ligaments
Cartilage Bursae
What are the function of Bones
- Provide structure for body
- Bear weight
- Protect organs
- Store Calcium
Classification of Bones:
Long bones
Short bones
Flat bones
Irregular bones
Where can you find Long bones
humerus and femur
Where can you find Short bone
wrist and ankle
Where can you find Flat bone
skull
vary in shape and have projections
skull- (Vertebrae and mandible)
what bone composition is composed of collagen fibers and calcium phosphate salts
Matrix
what bone composition lie between rings of matrix
Bone cells (osteocytes)
what are Two types of bone tissue:
Compact, Cancellous (spongey)
What bones are strong, rigid structure
Compact
What bones are less dense, forms internal portion of bone
Cancellous (spongey)
where is Bone Marrow found
Medullary cavity
What takes place in the Bone Marrow
Hematopoiesis
What are the function of Joints
- Form the union between bones
- Often allow for movement
What do most joints have?
ligaments, cartilage, bursae
- Absorbs shock
- Chondrocytes: produce collagen and -proteogylcans
- 80% water
Synovial joint
Articular or hyaline cartilage
May allow mobility or increased stability
Synovial joint-Ligaments
Help increase stability
Synovial joint-Menisci or labrum
Sacs filled with fluid
Synovial joint- Bursae
What type of DJD Not a true inflammatory disease May become inflamed at times Age group: most typically 45 and older 21 million people in US Primary: unknown Secondary: previous injury, repetitive stress, obesity, hemophilia, infection, hypermobility, repetitive stress
Osteoarthritis
Osteoarthritis (OA) - pathophysiology:
Surface of cartilage becomes rough, interfering with joint movement.
Tissue damage causes release of enzymes that accelerate disintegration of cartilage.
Bone underneath cartilage becomes exposed and damaged. Cysts and bone spurs (osteophytes) develop.
Pieces of bone spurs break off and cause irritation in the synovial cavity (can produce locking.)
Osteoarthritis (OA) – signs and symptoms:
Initially – mild, insidious pain that occurs with weight bearing and movement
Pain becomes more severe as degeneration process progresses
Limited joint movement
Enlarged, hard joint
Crepitus
NO SYSTEMIC SIGNS
Osteoarthritis (OA)-evaluation of Xray
Loss of jt space Sclerosis of bone ends Flattened shape of articular bone ends Osteophytes Usually affects hip, knee, shoulder, hands
What happens when Osteoarthritis affects the hip
Pain in groin to hip
Muscles: hip flexors, adductors and lat rotators
Mm weakness
Trendelenburg gait
What happens when Osteoarthritis affects the Knee
Quads atrophy
Genu varus gait
Ant jt pain with enlargement of jt
Ant knee pain
Osteoarthritis (OA) – treatment:
Minimize undue stress on joint
Assistive devices to minimize stress on joint (SPC, FWW)
Intraarticular injection of synthetic synovial fluid
Glucocorticoids
NSAIDS
Joint replacement + rehab
PT for OA
Increase function
Strengthen weak mm, increase endurance, home ex
Weight reduction
Regular exercise
Modalities: heat, ice, US, e-stim, massage, parrafin
List pg 177
Degeneration of vertebral discs
Affects apophyseal jts
Facet jts of spine
Spondylosis
This disease may be caused by
Poor posture
Heavy lifting
Prior injury
Spondylosis
What are these signs and symptoms
deterioration of disc
Lipping
Compression fractures, ligamentous thickening, inflammation
Spondylosis
This is the prognosis for what:(prognosis does vary w/ each pt)
MI: reduce pain, relieve neurological symptoms
Analgesics, anti-inflammatories
Decompressive surgery (radiculopathy or myelopathy)
Cortisone inj
Prognosis: Spondylosis
physical therapy for What?
Restore function
Postural re-ed, mm strengthening, flexibility, jt mobilization, pain relief
Spondylosis
Defect of pars interarticularis in lumbar spine
3-7% of population
Contact sports and gymnastics
Spondylolysis (2y’s)
Etiology for Spondylolysis
Microtrauma or genetic defect
Spina bifida occulta
S/S: usually L4/5 or L5/S1
Pain or find on xray
Medical intervention for Spondylolysis
diagnose with CT or MRY, x-ray, bone density
Treat with period of inactivity
Analgesics
PT for Spondylolysis
Abdominal and extensor strengthening
Postural re-ed
- Slippage of one vertebral body anteriorly on another
- Narrows spinal canal
- Usually L4/5 L5/S1
- Onset over 40 or in children
Spondylolisthesis
Etiology for Spondylolisthesis
trauma with fracture of pars interarticularis
S/S: of Spondylolisthesis
LBP better supine, mm spasm, Increased lordosis, referred pain
Prognosis: PT, analgesics, exercise, spinal fusion
medical intervention for Spondylolisthesis
fusion if severe
PT for Spondylolisthesis
strengthening, postural re-ed, avoid extension, support
See in young, old or immunosuppressed, drug abuse
Increased incidence with RA
STD: 80% of incidence in young
Infective Arthritis
Etiology of Infective Arthritis
bacteria; viral or metabolic disorders
Puncture, decubitus, strep, staph, pseudo, syphilis, gonorrhea, TB, Lyme
S/S of Infective Arthritis
if prolonged: jt damage. Usually 1 jt with severe pain, acute tenderness, inflammation
Prognosis of Infective Arthritis
life threatening or may resolve
Medical intervention Infective Arthritis
CT, x-ray, MRI, lab tests, Abx, drains
PT for Infective Arthritis
after infx is treated: progressive strenthening, stretching, endurance
